title: Neurotransmitters in cerebrospinal fluid reflect pathological activity.
abstract: The excitatory transmitters glutamate and aspartate become toxic whenever their extracellular levels are increased because of neuronal, glial and endothelial impairment. Taurine, a volume-regulating amino acid, is released upon excitotoxin-induced cell swelling. Our aim was to investigate if glutamate and aspartate in cerebrospinal fluid (CSF) reveal neuropathology in neurological patients, and if taurine unmasks glutamate-mediated toxicity. Glutamate and aspartate are doubled in viral meningitis, acute multiple sclerosis (MS) and myelopathy compared with control subjects and patients with peripheral facial nerve palsy. These levels do not coincide with a disturbed blood-brain barrier, as estimated by the albumin ratio, are independent of their precursors (glutamine, asparagine) and are not associated with cell lysis. Taurine is significantly increased in meningitis, acute MS, and myelopathy, suggesting glutamate-mediated toxicity. Analysis of transmitters in lumbar CSF can be used to identify patients with cerebral and spinal pathology who might benefit from specific receptor-modulating agents.
authors.affiliation: Institute for Neurosurgical Pathophysiology, Mainz, Germany.
authors.forename: J F
authors.initials: JF
authors.lastname: Stover
authors.forename: U E
authors.initials: UE
authors.lastname: Pleines
authors.forename: M C
authors.initials: MC
authors.lastname: Morganti-Kossmann
authors.forename: T
authors.initials: T
authors.lastname: Kossmann
authors.forename: K
authors.initials: K
authors.lastname: Lowitzsch
authors.forename: O S
authors.initials: OS
authors.lastname: Kempski
mesh_terms: D000328:Adult; D000368:Aged; D001216:Asparagine / Q000134:cerebrospinal fluid; D001224:Aspartic Acid / Q000134:cerebrospinal fluid; D001812:Blood-Brain Barrier; D002493:Central Nervous System Diseases / Q000134:cerebrospinal fluid* / Q000201:enzymology / Q000473:pathology* / Q000503:physiopathology; D005260:Female; D018698:Glutamic Acid / Q000134:cerebrospinal fluid; D005973:Glutamine / Q000134:cerebrospinal fluid; D005998:Glycine / Q000134:cerebrospinal fluid; D006801:Humans; D007770:L-Lactate Dehydrogenase / Q000134:cerebrospinal fluid; D008297:Male; D008875:Middle Aged; D018377:Neurotransmitter Agents / Q000134:cerebrospinal fluid*; D012694:Serine / Q000134:cerebrospinal fluid; D013654:Taurine / Q000134:cerebrospinal fluid
chemical_list: D018377:Neurotransmitter Agents; D005973:Glutamine; D013654:Taurine; D001224:Aspartic Acid; D018698:Glutamic Acid; D012694:Serine; D001216:Asparagine; D007770:L-Lactate Dehydrogenase; D005998:Glycine